Neural alcohol cue reactivity as a risk factor for future drinking in youth with limited alcohol exposure

Heightened alcohol cue reactivity is associated with alcohol problems and poor alcohol use disorder outcomes. Theory suggests that this reflects a conditioned response, whereby cues repeatedly paired with chronic alcohol use become more salient. However, few studies have investigated the relative emergence of heightened alcohol cue reactivity. It is possible that this response occurs very early in individual drinking trajectories and may play a role in shaping future alcohol use behavior.

We tested this hypothesis in a sample of youth (n = 159; ages 16-19) with limited lifetime alcohol exposure (<100 lifetime drinks). Participants completed a baseline cue reactivity task in which they viewed images of alcoholic beverages, high-calorie foods (reward control), and neutral objects. The late positive potential (LPP), measured using electroencephalography, is a positive-going event-related potential measured 400 ms after a visual cue. The LPP was used to index cue reactivity and scored as the average amplitude from parietal site Pz. At baseline and 12 months, participants completed a retrospective calendar of alcohol use. Participants were classified into groups based on lifetime alcohol exposure: (1) ≤ 10 drinks (n = 50), (2) ≤50 drinks (n = 74), (3) >50 drinks (n = 35).

We ran a repeated measures analysis of variance to compare the effects of task condition (alcohol cues/food cues > neutral) and drink groups on LPP amplitude. Our results revealed a significant condition × drink group interaction. Follow-up analyses revealed that, for alcohol cues only, there was a significant group effect. The highest drink exposure group exhibited greater LPP relative only to the low drink exposure group. Next, we examined whether baseline LPP to alcohol cues predicted total drinks consumed 12 months later, while controlling for baseline drinking behavior. Greater LPP to alcohol cues was associated with an increase in drinks consumed at one year.

Heightened alcohol cue reactivity emerges with limited alcohol use and can be predictive of future drinking behaviors.